Overview
Anal fissures and hemorrhoids are both common conditions affecting the anal region, often causing pain or bleeding during bowel movements. An anal fissure is a small tear in the skin of the anal canal, typically causing sharp, severe pain and bright red bleeding. Hemorrhoids are swollen veins in the rectum or anus that may cause itching, discomfort, or painless bleeding. While both can result from constipation or straining, their causes, symptoms, and treatments differ.
Disease Summaries
Anal Fissures: Anal Fissure, also known as an anal tear, is a common condition characterized by a small tear or cut in the lining of the anus. It is often caused by trauma to the anal area during bowel movements, such as passing hard stools or excessive straining. Symptoms include intense pain, bleeding, and itching. Risk factors include chronic constipation, obesity, and pregnancy.
Hemorrhoids: Commonly known as piles, hemorrhoids are swollen areas around the anus, where feces are excreted from the body. They can form inside or outside the anus, often due to excessive straining or poor blood flow, and may result in painless bleeding.
Comparing Symptoms
Overlapping Symptoms
- Rectal bleeding (usually bright red)
- Pain or discomfort during bowel movements
- Itching or irritation around the anus
- Often linked to constipation or straining
Anal Fissures Specific Symptoms
- Sharp, burning pain during and after bowel movements
- Visible tear or crack near the anal opening
- Muscle spasms in the anal area
- Bleeding may be seen on toilet paper or in the toilet bowl
Hemorrhoids Specific Symptoms
- Swelling or lumps near the anus (external hemorrhoids)
- Painless bleeding during bowel movements (internal hemorrhoids)
- Possible leakage of stool or mucus
Treatment Approaches
Anal Fissures Treatment Approaches
In mild cases, your doctor may recommend creams, ointments, or warm baths to relieve pain and discomfort, as well as recommend lifestyle changes, such as avoiding sitting for extended periods and increasing fiber intake. In more severe cases, minimally invasive procedures may be required.
Hemorrhoids Treatment Approaches
Piles can initially be treated with simple home remedies like increasing fiber intake and using sitz baths. Other options include creams, procedures like rubber band application, and surgeries.
Reviewed By:

Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.

Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on May 1, 2025
Following the Medical Content Editorial Policy
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https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htmTalaie R, Torkian P, Moghadam AD, Tradi F, Vidal V, Sapoval M, Golzarian J. Hemorrhoid embolization: A review of current evidences. Diagn Interv Imaging. 2022 Jan;103(1):3-11. doi: 10.1016/j.diii.2021.07.001. Epub 2021 Aug 27. PMID: 34456172.
https://www.sciencedirect.com/science/article/abs/pii/S2211568421001704?via%3DihubAkinmoladun O, Oh W (Year). Management of Hemorrhoids and Anal Fissures. The Surgical clinics of North America.
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